Autologous anatomic breast implant: molding the latissimus dorsi flap.

The latissimus dorsi flap is enjoying resurgence in interest for breast reconstruction. A technique is described in which the pedicled latissimus dorsi flap (the whole muscle and overlying fat is harvested) is molded to resemble the shape of a breast. This enhances the shape and projection of the reconstructed breast, and prosthesis is no longer required. The disadvantages of the technique are the longer scar that is required to harvest all the muscle and overlying fat, and that there is still some limitation to the size of the breast that can be reconstructed. Harvesting the extended latissimus dorsi flap also leaves a contour defect on the back.